SARA PHARMACY NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

At Sara Pharmacy, we are committed to protecting your medical information. We create a record of the care and services you receive to provide you with quality care and to comply with legal requirements. This notice applies to all of the records of your care generated by the pharmacy.

I. OUR PLEDGE REGARDING MEDICAL INFORMATION

We understand that medical information about you and your health is personal. We are required by law to:

  • Make sure that medical information that identifies you is kept private.
  • Give you this notice of our legal duties and privacy practices with respect to medical information about you.
  • Follow the terms of the notice that is currently in effect.

II. HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose medical information:

1. For Treatment

We may use medical information about you to provide you with medical treatment or services. For example, we may use your information to dispense prescription medications. We may disclose medical information about you to doctors, nurses, or other healthcare professionals who are involved in your care.

2. For Payment

We may use and disclose medical information about you so that the treatment and services you receive at the pharmacy may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about a prescription you received so your health plan will pay us or reimburse you for the medication.

3. For Healthcare Operations

We may use and disclose medical information about you for pharmacy operations. These uses and disclosures are necessary to run the pharmacy and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.

4. Appointment Reminders and Refill Notifications

We may use and disclose medical information to contact you as a reminder that you have an appointment or that a prescription is ready for pickup or needs to be refilled.

III. SPECIAL SITUATIONS

We may use or disclose medical information about you without your permission in the following circumstances:

  • As Required By Law: We will disclose medical information about you when required to do so by federal, state, or local law.
  • Public Health Risks: We may disclose medical information about you for public health activities, such as preventing or controlling disease, injury, or disability.
  • Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
  • Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order.

IV. YOUR RIGHTS REGARDING MEDICAL INFORMATION

You have the following rights regarding medical information we maintain about you:

  • Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care.
  • Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.
  • Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, and healthcare operations.
  • Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations.
  • Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.

V. CHANGES TO THIS NOTICE

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the pharmacy.

VI. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the pharmacy or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Contact Information

Sara Pharmacy

652 East 233rd St, Bronx, NY 10466

Phone: (718) 696-1500

Email: [email protected]

Effective Date: October 2023